A guide to the PIX Survey structure, scoring, CMS reporting requirements, and its role in inpatient psychiatric care
Patient experience is an essential aspect of healthcare delivery and has been demonstrated to correlate with patient outcomes in several contexts. The Psychiatric Inpatient Experience (PIX) Survey was developed in 2021 to reliably assess the experience of patients that undergo inpatient psychiatric care.
This 23-item questionnaire encompasses four domains of patient experience including healing environment, treatment effectiveness, nursing and team presence, and treatment team relationship. Each question is scored on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree) with an option of “does not apply” for each question.
Scoring of this tool can be performed on a domain-basis or a total score. Domain scoring utilizes the average score of all questions within that domain. The total score can be calculated as the average score of all questions completed (excluding those answered “does not apply”) for the entire survey.
CMS Adopts the PIX Survey for Inpatient Psychiatric Facility Quality Reporting (IPFQR)
As part of the Inpatient Psychiatric Facility Quality Reporting (IPFQR), the Centers for Medicare & Medicaid Services declared that the PIX survey will be adopted into mandatory reporting for inpatient psychiatric facilities. Beginning in the calendar year 2027, CMS will require reporting of PIX survey data for all patients older than 13 that are discharged from inpatient psychiatric facilities with voluntary reporting beginning in calendar year 2025.
CMS Reporting Requirements for the PIX Survey:
- This survey can be administered within 24-hours prior to planned discharge and must be administered in a way that maintains anonymity of the patient, either electronically or through paper format.
- In the event that the survey does not get completed prior to discharge, the form must be given to the patient with an addressed, sealable, stamped envelope so that the patient can return the form with ease.
Strengths of the Psychiatric Inpatient Experience (PIX) Survey
The PIX Survey is one of the first of its kind to measure patient experience within the inpatient psychiatric realm. This survey will soon have wide-spread use with its recent adoption into the IPFQR guidelines, allowing for a more robust analysis of its psychometric properties and utility.
Considerations and Limitations of the PIX Survey
Despite its rapid integration into healthcare policy following its creation, there is relatively little research regarding the psychometric properties of this tool. Additionally, no normative values have been published for this tool. Further work is needed to discern how this tool might differ among various populations and patient cohorts, as well as how responses from this tool might be used in quality improvement initiatives within an institution.
Costs and Licensing for Using the PIX Survey
This tool is readily available online and does not require any licensure, registration or fees for use.
“Because the measure developer has made the PIX survey available in the public domain, there is no certification or license required to administer the PIX survey.”
– Federal Register / Vol. 88, No. 147 / Wednesday, August 2, 2023 / Rules and Regulations p. 51127
Conclusion: The Future of Patient Experience Measurement in Psychiatry
The PIX Survey is a newer tool designed to quantify patient experience within the inpatient psychiatry realm. While it shows promise in analyzing and improving patient experience for this cohort, more research is needed for actionable guidance regarding post-collection utilization of this tool.
Schedule A Call With a PRO Expert!
We’ll set up and manage your PROs for high capture rates and actionable data
—so you can focus on what truly matters: patient care.